Tag Archives: Genetic

This article leads in with “Shoddy biopsies deny cancer patients a shot at personalized treatment”. Biopsy samples taken from patients with advanced cancer, were collected by doctors in hundreds of clinics nationwide. When researchers checked them, they found as many as 1 in 5 didn’t have enough malignant cells to analyze, in most cases because the biopsy had been poorly done. This glitch raises troubling questions about the new era of precision medicine. The article goes on to report “biopsies done in rural or community centers were more likely to be shoddy”. Those patients’ tumors couldn’t be analyzed and they couldn’t be matched with medicines targeted at their specific genetic mutations. And that suggests that access to the most advanced, customized cancer treatments might be highly unequal — and dependent on the quality of the local doctors performing biopsies. Perhaps “shoddy” is a strong word when trying to balance the need of being minimally invasive to arrive at a tissue diagnosis versus having enough tissue/tumor cells for additional molecular analysis. Larger biopsies carry the risk of more potential complications while less invasive procedures that may be sufficient for accurate grading/staging may be insufficient for downstream analysis.

STAT reported that the MATCH trial, launched last year by the National Cancer Institute, “has run into an unexpected roadblock: Many of the tumor samples aren’t robust enough to be put through genetic analysis.” According to STAT, the issue “raises troubling questions about the new era of precision medicine.” The article pointed out that though interventional radiologists usually aim to take as small a biopsy as possible to avoid infection and other risks, “only larger and more invasive biopsies can provide the type of genetic information needed for personalizing therapy.” Dr. Michael Thompson, incoming chair of the Community Research Forum Council at the American Society of Clinical Oncology, said, “You have these competing issues of trying to minimize toxicity from the procedure and trying to get optimal tissue.”

“Personalized medicine” for years to come will be forced to deal with “diagnostically” suitable tissue samples versus “more tissue for molecular analysis”.